Is my doctor right to prescribe contraceptive pill for my endometriosis?

• What manner of disease is this?

Dear doctor,

I’m 29 years old and currently undergoing my youth service. Last year, I had severe abdominal pain and the doctor recommended an abdominal scan. I was told the scan did not reveal  anything serious but the doctor said there are some fibroids which should not cause any serious problem. The pain started again three weeks ago and another doctor recommended a  scan. She said I have endometriosis. She gave me some tablets which she said I should take for two months. I’ve since discovered that the drug is actually a contraceptive. Doctor am I on the right path?  I’m not sexually active and there’s just no reason for me to go on a contraceptive, especially when I’m not yet married. Will this not affect my ability to have children in future? What manner of disease is endometriosis? What could be the cause? Please help.

Alaba, Ibadan

Dr. Okon says:

From the so many questions asked within one paragraph, almost back to back, I can sense some anxiety …please calm down….

I’m actually impressed by your health-seeking behaviour and quest to know more about your body and how it works. Good one. Let’s talk about Endometriosis:

What is Endometriosis?

A disorder in which tissue that normally lines the uterus grows outside the uterus.

With endometriosis, the tissue can be found on the ovaries, fallopian tubes or the intestines.

How common is it?

It’s a quite common disorder with a prevalence of about 100,000 cases annually in Nigeria alone.

At Seckin Endometriosis Center in New York City in 2019, a consulting surgeon with the Endometriosis Foundation of America (EFA), Dr Karli Goldstein (who has endometriosis herself) said “At least 1 in 10 women have endometriosis but is being under-diagnosed. It can take up to 10 years to make the diagnosis, especially if the symptoms are atypical”.

What are the common symptoms associated with Endometriosis

The most common symptoms are pain and menstrual irregularities, as you mentioned above. There could also be pain during sexual intercourse (dyspareunia) and it may also cause infertility.

How can it be managed?

This depends on the severity.  Some people can decide to do a watchful waiting, also known as “palliative care” while some people may just treat the symptoms and wait. However, other treatment options that can be adopted may include:  

Hormonal therapy, to shrink the tissue, which is where the contraceptive comes in, but it’s not being used to “prevent pregnancy,” rather, the hormonal contents (Oestrogen and Progestin) are being used for the treatment. Ablation and Surgery can also be used.

Endometriosis needs expert management by a Gynaecologist. Please follow up with one.

Best wishes.

IO

Do you have a health problem? Write now in confidence to:  imeokon@nigeriahealthonline.com for an advice or simply visit www.nigeriahealthonline.com to chat with Dr. Ime Okon.